[unreadable] The interaction between cancer patients and their healthcare providers during the medical visit is complex and greatly impacts patients during the course of diagnosis and treatment. To date, however, research on the interactions has almost exclusively focused on the physician-patient dyad despite the fact that there are frequently multiple healthcare providers involved in the patient's care. The overall goal of this study is to comprehensively examine the interaction and communication patterns between patients with metastatic cancer of unknown primary (CUP), their primary oncologists, and the other healthcare providers involved in the patients' care during their outpatient visits. The specific objectives are to: 1) describe the meanings and patterns of communication between patients with CUP, their primary oncologists, and fellows, residents or PAs who participate in their care; 2) compare the patterns of communication exchange between the patient and provider(s) when more than one healthcare provider (primary oncologist and fellow, resident or PA) is involved in the medical visit versus when only one provider (medical oncologist) is involved; and 3) examine the role of gender of the patients and the providers on the nature of the communication during outpatient oncology visits. This will be accomplished by analyzing digital recordings of initial visits of patients with CUP that were collected as part of the Principal lnvestigator's K07 project of illness uncertainty and communication on psychosocial adjustment. The recordings were initially collected to examine how uncertainty was discussed, however, they provide a unique opportunity to investigate other important communication processes such as how having multiple providers involved in the visit may influence the communication. The research will use both qualitative and quantitative methods to address the research questions. Data collected from this study will be used as the foundation for additional research in the area of health care provider-patient communication including the development and testing of educational interventions for both providers and patients. [unreadable] [unreadable]